LEYDA MELENY ROMAN NIEVES, MD
NPI 1881850428, individual, Humacao, PR, Pediatrics
- Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 26.6 | 4.5 | 3.0 | 4.1 | 232 | 2 | 99213 99222 99232 | $23K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | LEYDA MELENY ROMAN NIEVES, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | August 4, 2008, last updated April 7, 2020 |
| Practice location | URBANIZACION EL RECREO, CALLE RAFAEL ROSARIO ARROYO #46, Humacao, PR 00791, 787-852-1355 |
| Mailing address | #33 CALLE FANTASIA, CUIDAD JARDIN URB LOS SUENOS, Gurabo, PR 00778 |
| Specialties | Pediatrics (208000000X, primary, license 18286 PR) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $16K | 42% | $2.13 | $44 (top 5% from $110) | 6th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $15K | 38% | $209 | $67 (top 5% from $174) | too few months to rank | |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $6K | 15% | $81 | $63 (top 5% from $137) | too few months to rank | |
| 99245 | Medicaid service code | $1K | 4% | $9.31 | $153 (top 5% from $281) | 4th percentile | |
| 99234 | Initial hospital care with same-day admission and discharge with straightforward or low level of medical decision making, per day, if using time, at least 45 minutes | $504 | 1% | $30 | $98 (top 5% from $194) | too few months to rank | |
| 99217 | Medicaid service code | $260 | 1% | $4.40 | $39 (top 5% from $79) | too few months to rank | |
| 99408 | Alcohol/substance screening and brief intervention 15-30 min | $0 | 0% | $0.00 | $0.49 (top 5% from $42) | too few months to rank | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $0 | 0% | $0.00 | $60 (top 5% from $133) | too few months to rank |
In this area
3 providers in Humacao Municipio County, PR carry an indicator in the public record, with $405K at stake between them. The most common is more hours than a day holds, on 3 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | VIMARIE FLORES Humacao, PR, ranked 8021 | $222K |
|
| 5 | GLENDA AYALA-RIVERA Humacao, PR, ranked 10463 | $89K |
|
| 5 | NANCY RIVERA Humacao, PR, ranked 11637 | $94K |
Recent enforcement in PR
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.